1.2 Situation in the Republic of Korea

1.2.1 Joining the United Nations

On 26 October 1979, President Park Chung-hee, who had led the country for 19 years, was assassinated. The incident led to a transformation in the nation’s politics. After a period of political ferment, a democratic government based on the single-term presidency system was established.

The end of the Cold War also brought many changes. The Republic of Korea established diplomatic relations with Eastern European countries such as Hungary and Poland in 1989, with the Union of Soviet Socialist Republics in 1990, and with China in 1992. Moreover, in 1991, the Republic of Korea, together with the Democratic People’s Republic of Korea, joined the United Nations (4).

During this period, the economy of the Republic of Korea maintained high growth, mainly driven by the heavychemical industry. The Republic of Korea was gradually transformed from an aid-recipient country to an emerging donor country.

The Government established the Economic Development Cooperation Fund (EDCF) in 1987 to manage concessional loans of the Republic of Korea’s official development assistance, and the Korea International Cooperation Agency (KOICA) in 1991 to manage official development assistance (5). In 1996, the Republic of Korea became a member of the Organisation for Economic Co-operation and Development (OECD). Its gross domestic product (GDP) per capita, measured in current US dollars, exceeded US$ 10 000 in 1994 (6).

rant p hoto / Milton g un ©

Q The republic of Korea joined the united nations along with the democratic people’s republic of Korea in 1990. officials attend their first flag-raising ceremony at the united nations headquarters in new york.

1.2.2 Rapid expansion of health insurance coverage and epidemiologic transition

iiNtroductioN of the compulsary health iNsuraNce system

The most noticeable features of the health-care system during this period were the rapid expansion of insurance coverage and the subsequent popularization of health-care services. A compulsory health insurance system, which was introduced in 1976 for employees of large companies, was expanded to cover all employees by 1988 and to all self-employed people in 1989, excepting those subject to the government medical aid programme.

After the introduction of the mandatory health insurance system, the Government proactively pursued the expansion of health-care infrastructure in rural areas to effectively deal with the increasing use of health services. On 31 December 1980, the Government proclaimed the Act on the Special Measures for Public Health and Medical Services in Agricultural and Fishing Villages, and from 1981 it began to deploy public health doctors to health sub-centres in myeons in lieu of military service, and community health practitioners to Community Health Posts in remote villages. In addition, the number of non-profit private health providers increased. During this period, total health expenditure increased significantly from 1.4 trillion won in 1980 to 18.6 trillion won in 1996 (7).

establishmeNt of the miNistry of eNviroNmeNt

Having considered the growing importance of the environment, the Government established the National Environmental Agency under the umbrella of the Ministry of Health and Social Affairs (MOHSA) in 1980. It was upgraded to the National Administration of Environment in 1990 and subsequently to the Ministry of Environment in 1994 (8). At that time, MOHSA was renamed to the Ministry of Health and Welfare (MOHW) (9).

e nvironment © Ministry of

Q The government of the republic of Korea established the national environmental agency under the umbrella of the Ministry of health and social affairs in 1980.

epidemiologic traNsitioN aNd the NatioNal health promotioN act

While major health issues, such as the control of communicable diseases, further stabilized, noncommunicable diseases emerged as leading causes of death. According to the Korea National Statistical Office, the number of deaths due to cerebrovascular diseases per 100 000 population rose slightly from 19.6 in the late 1950s to 26.1 in the late 1960s, but skyrocketed to 69.2 in 1981 and 73.3 in 1988. The number of deaths caused by cancer per 100 000 population increased from 73.6 in 1983 to 91.8 in 1985 and 114.6 in 1997 (10). To tackle these issues, the Government enacted the National Health Promotion Act in 1995, thereby setting the legal foundation for health promotion projects that included non-smoking policies such as restrictions on cigarette advertising and mandatory health warnings on cigarette packages.

During this period, the average life expectancy at birth grew from 65.7 years in 1980 to 74.0 years in 1996. The total fertility rate decreased from 2.73 in 1980 to 1.57 in 1996. According to census data, the total population was 37 406 815 people in 1980, and increased to 44 553 710 people by 1995. The proportion of the total population that was over 65 years old reached 5.9% in 1995 (11).